Transcript Example of Good Practice in Drug Dependencies approaching

Example of Good Practice in Drug
Dependencies approaching Roma
Community from Bratislava
Lubomir OKRUHLICA, Zuzana BUSOVA
Bratislava, Slovakia
“Transnational good practices and experiences exchange
on drug dependencies within the Roma Community”
Budapest, 29th and 30th October 2004
Demography- Statistics
• Slovak Republic .......5,379,455 inhabitants........in 2001
• Roma population (1,7%)....89,920 Roma people...officially
...320,00 Romas unofficially
Demography- Statistics
Life expectancy - males:
• in general Slovak population - 66.5 years
• in Roma community
- 54.5 years (less 12 years)
Life expectancy - females:
• in general Slovak population - 76.5 years
• in Roma community
- 68.5 years (less 8 years)
Living conditions
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Mostly rural settlements with overcrowded dwellings;
absent innoxious potable water;
sewage system cesspits for waste water;
accumulating solid quickly decaying communal waste;
no adequate access road.
Health risk factors
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Lower level of education;
low personal hygiene standard resulting e.g. in hepatitis A;
low communal hygiene standard;
unhealthy boarding habits, improper nutrition;
increased rate of taking alcohol and tobacco products;
growing drug addiction resulting in higher risk of HIV
infection and B and/or C hepatitis.
Concrete measures
1.) Simultaneous improvement in the sectors of employment,
education and housing;
2.) improve access to health care;
3.) enhancing public health awareness;
4.) increase the rates of vaccination;
5.) organize health centers in Roma communities;
Concrete measures
6.) education> on personal hygiene
> avoidance of toxic substances
> sexual behavior, reproductive health
> drug use
Drugs in Roma community
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Tobacco and alcohol is commonly used;
especially there is a high rate of smoking up to 100%;
cigarettes are very popular among many Roma children ;
sniffing of inhalants by youngsters mostly in poor rural
Roma settlements;
Drugs in Roma community
• opiates - heroin is the most prevalent of illicit drug in
Roma community;
• and illicit use of non-prescribed sedatives (such Rohypnol)
is quite common;
• less cannabis and stimulants;
• differences between rural and city population in drug
consumption.
Drugs in Roma community
• More self-medication - less experimental drug usage;
• due to high stress in poor living conditions;
• smuggling as the way of living.
Drugs in Roma community
Access to assistance resources for drug dependents is
different in the capital city and different in rural areas.
Extended Roma families - children copying parents behavior,
- problem to find drug, tobacco and
alcohol-free environment in many
Roma households.
Examples from our practice
1. ’OPRE ROMA!’ - drug prevention (2000);
2. ‘Roma anti-drug forum’ - drug education (2003);
3. Approaches in drug treatment to Roma clients/patients.
’OPRE ROMA!’
Goals:
- to extend the Program on public health to the Roma
community with special targeting on prevention of
HIV/AIDS, hepatitis A,B, C and on prevention of
psychoactive substance abuse;
- to improve degree of co-operation of health care workers
with NGOs with priority given to Roma ethnic;
’OPRE ROMA!’
- to educate the key persons from Roma community on
health issues;
- harm reduction caused by drug use (e.g. HVB vaccination);
- counseling for Roma families with drug problems.
‘Roma anti-drug forum’
Goals:
- motivating and the involvement of the members of Roma
community in Bratislava into drug prevention activities;
- education of Roma community on negative health and social
consequences of psychoactive substance use;
- harm reduction;
- facilitation of overcoming the resistance of Romas to use
specialized health services for drug users;
- family counseling.
Approaches in drug treatment
At the Centre for Treatment of Drug Dependencies in
Bratislava:
• non-judgmental approache without prejudices to the
minority;
• expressing empathy and respect to their civic rights;
• co-operation with the elders from local Roma community;
Approaches in drug treatment
• sensitivity to and taking into account different cultural
aspects;
• fair and equal access to all health care treatment services;
• not special, selected, ethnically targeted treatment
programs for Romas (!)
Strategy for 2003-2010
• Create more optimal for implementing the health projects
locally and in co-ordination.
• Carry out a research of health status of inhabitants of
Roma settlements.
• Improve co-ordination of programs focused on health
status and provision of health care services to Roma.
• During the following five years it is necessary to increase
the percentage of vaccination in Roma settlements up to
95%.
Strategy for 2003-2010
• Extension of networks of health care assistance for Roma
settlements.
• Support and extended network of health care assistance,
who are expected to provide health care mainly to children
and mothers, even through fieldwork.
Strategy for 2003-2010
Aims could be:
- to improve and facilitate doctor-patient relationship;
- to increase the accessibility of health services for Romas;
- to increase the efficiency of preventive and curative services;
- to increase the level of health education for Romas;
- mobilizing Roma families in taking part in vaccination;
- facilitating access for Roma women to family planning.
All these should include specific issues on drugs, alcohol and
tobacco consumption.
Suggestion from our experience
• Education of majority population on prejudices against
Roma people.
• Education of majority population on racism and racial
discrimination issues - human rights.
• Education majority population on Roma cultural issues.
Thank you for your attention!
[email protected]